this was in my paper today. i am not suprised to say the least. i did my clinicals at one of these hospitals mentioned. and as they are consolidating the two hospitals around here to just one, alot... Read More

Mar 14, '08

elkpark, since you work for the state maybe you know because i am really wondering, what is the deal with the whole dix/butner/umstead situation? are they really closing dix??

Mar 14, '08

Don't get me started on the "reform" plan -- it has turned out to be exactly the disaster many of us predicted when it was just a proposal, as noted in the article you posted (check out, also, any other articles the N&O has published on the current mental health situation -- I know the Chlt Observer has done a bunch of great articles; I'm sure the N&O has either written some, also, or picked up the Observer articles ...) The whole situation is extremely sad and infuriating.

As the article you posted describes, the plan all along (for the last several years, the centerpiece of the "reform" plan), has been to close both Dix and Umstead, and open one new hospital to replace them; a hospital which, by the way, has fewer than half the number of beds of Dix and Umstead (currently) combined ... However, your article reports that has now been held up because of problems with the new building. It's just a matter of time, though, apparently. The official rationale is because the buildings on both campuses (Dix and Umstead) are too outdated and inadequate for modern psychiatric care, and it would cost less to build a new hospital than to renovate them again (Umstead was not even originally built to be a psych hospital), but it's widely believed that the real reason is that the Dix campus is the last large, undeveloped parcel of land in the downtown Raleigh area, and there are just too many private developers wanting to get their hands on it, and too much $$$ to be made off it, for the state to resist ...

BTW, just for the sake of accuracy, I don't currently work for the state of NC. I still have friends/colleagues who do, though, and they keep me reasonably up to date.

Sad story. I have worked in a county mental faciility in California. Patients have a patients right phone number, posted where they can report abuse. I am happy to say . that from my observations, patients were well protected from abuse. North Carolina seems to be still back in the 50's era. That is too bad, some states are far behind in progress.

I have heard patients say that they are restricted from using the phone, though, sometimes, including their ability to access the state hotline number that inpatients are supposed to be able to use to report abuse, neglect, and other maltreatment from the staff or other patients.

I have heard patients say that they are restricted from using the phone, though, sometimes, including their ability to access the state hotline number that inpatients are supposed to be able to use to report abuse, neglect, and other maltreatment from the staff or other patients.

Is that legal?

Well, in the first place, not everything clients (or staff, for that matter!) say is true. I've heard all kinds of things from clients over the years that I knew for a fact were not true; sometimes it's simply a misunderstanding or lack of info, sometimes it's an intentional lie.

In the second place, NC (the only state I know about first hand, but I'm sure there are similar mechanisms in other states) does have a legal means by which clients' phone use can be restricted when necessary. It requires a physician's order and a detailed explanation in the client record, by the attending physician, of why the restriction is necessary (the situation/actions leading to the restriction), and the restriction is time-limited and must be reviewed/renewed by the treatment team every seven days (must document in the record, in detail, why the restriction is still necessary).

Now, having said that, that doesn't mean that there couldn't be places (or individual staff people) that simply flout the rules and keep people away from the 'phone for no good reason ... As has already been said on this thread, bad things happen all the time, in lots of places. But there would be serious consequences if they happen to get caught.

Staff are put in a difficult situation when clients have a legal/civil right to have access to the telephone, but they are repeatedly making harrassing telephone calls to family members, etc., or are using the telephone to maintain dysfunctional relationships that are clearly damaging their progress in treatment, or calling their drug dealer to ask him to come visit and smuggle in some merchandise, or repeatedly calling law enforcement agencies, etc., to complain that they're being held against their will and need the police, sheriff, etc., to come get them out ... Families and law enforcement personnel seem to have a very hard time grasping the concept that psychiatric clients have a right to use the telephone and we are not legally allowed to stop them from calling every ten minutes ... (One memorable evening early in my career, I found myself on the telephone (I was lucky enough to be the 2nd shift charge nurse, so I got to field all these 'phone calls in the evenings) with an FBI supervisor calling from FBI headquarters in DC to order me (haha!) to stop a client from repeatedly calling the regional FBI office to report the illegal conspiracy that was keeping him locked up on our psych unit against his will to keep him from warning the government about the danger to the President ... I explained to the FBI supervisor, like I did to everyone else who called with similar requests/orders, that the client had a right to use the telephone and we were not going to be violating that right -- the FBI could just deal with the calls however they saw fit. He clearly did not consider that a helpful response ... )

Those are the kind of situations, though, that led to a process being developed to allow treatment teams to restrict a client's usual rights to communicate with "the outside world."

I'm sure that was a much longer response than you were looking for! The short answer is, yes, it can be legal to keep people from using the 'phone.

Don't get me started on the "reform" plan -- it has turned out to be exactly the disaster many of us predicted when it was just a proposal, as noted in the article you posted (check out, also, any other articles the N&O has published on the current mental health situation -- I know the Chlt Observer has done a bunch of great articles; I'm sure the N&O has either written some, also, or picked up the Observer articles ...) The whole situation is extremely sad and infuriating.

As the article you posted describes, the plan all along (for the last several years, the centerpiece of the "reform" plan), has been to close both Dix and Umstead, and open one new hospital to replace them; a hospital which, by the way, has fewer than half the number of beds of Dix and Umstead (currently) combined ... However, your article reports that has now been held up because of problems with the new building. It's just a matter of time, though, apparently. The official rationale is because the buildings on both campuses (Dix and Umstead) are too outdated and inadequate for modern psychiatric care, and it would cost less to build a new hospital than to renovate them again (Umstead was not even originally built to be a psych hospital), but it's widely believed that the real reason is that the Dix campus is the last large, undeveloped parcel of land in the downtown Raleigh area, and there are just too many private developers wanting to get their hands on it, and too much $$$ to be made off it, for the state to resist ...

BTW, just for the sake of accuracy, I don't currently work for the state of NC. I still have friends/colleagues who do, though, and they keep me reasonably up to date.

thank you for the update. i find it really sad myself, i know dix is old but it is a huge peice of land, it would make more sense to build a more up to date hospital on the land there and then transition the patient over and knock the old one down. one of the nurses there told me they were making a dog walking park or something out of the land. i guess i just didnt believe that they were actually shutting it down....

i was at food lion the other day, and i saw one of my patients from clinicals, who is a very unstable and violent schizophrenic, there with his sister. she recognized me and came to say hello, and she could see my jaw was about on the floor and she said "well, it was either we take him, or he lives homeless on the streets, because dix discharged him".

anyway, sorry for opening up the subject, i live in downtown raleigh so it is definately a cause i am interested in..